Friday, 25 January 2013

Liverpool Care Pathway - Of Deception And Infamy

There are famous - and infamous -
tales of deception and counter-deception from times of war, of one side
attempting to hoodwink and out-best the other to gain some advantage
of strategy. One such tale from the Second World War was made into a film
called, "The Man Who Never Was".

No war is good, but sometimes it is necessary to fight the good
fight and that has to be what the Second World War was about.

No battle is undertaken lightly, but battle we must and stand up
and be counted amongst those few who will stand up and be counted and, with
righteous anger, declare a wrong to be wrong!

No war is good but that is what we fight, and it is the good
fight we fight. And this tale we tell is also of deception and
counter-deception. The tale - "The Group That Never Was" (a.k.a. The Once and Future Group).

I am attempting to clarify the actual status of the following named groups, their constitution and membership, in order to validate their existence. They are each named as co-authors or made as reference of at least one publication.

The National Nurse Consultant Group (Palliative Care)

The Consultant Nurses in Palliative Care Reference Group

The National Palliative Care Nurse Consultant Group

The National Group of Palliative Care Nurse Consultants

TheNational Group of Palliative Care Nurse Consultant

Do they exist independently or is one a misnomer for one or more of the aforementioned? If independent organisations, how may they be contacted, please, in order to ascertain their constitution and status?

I can confirm that the groups mentioned in 1-5 below are the same group of which I am chair. Our terms of reference are as follows:

Our purpose as a group of nurse consultants is to promote palliative care nursing within a multi-professional context

AS NURSES IN PALLIATIVE & END OF LIFE CARE WHAT DO WE DO?

Our terms of reference are as follows:

· To provide a critical body of expert nursing opinion
· To influence nursing practice at local, network & national levels
· To articulate nursing practice to influence policy
· To identify areas of nursing practice in need of further development by research and education
· To contribute a nursing voice to debate affecting delivery of palliative and end of life care
· To provide diverse nursing knowledge and expertise supporting service development

Good evening,
Thankyou for your kind response.
You state that the groups mentioned in 1-5 below are the same group of which
you are chair. May I ask what is the formal name of the group, please?

Further to my email, is the group formally structured, please? Is there a board
of members and what is its make-up? What formal qualifications do they hold? To
whom is membership open and what is the extent of that membership?

On what basis did the DoH and NHS commission your group to write care documents
for publication? Does the group receive funding for its work and from whom? Is
the group registered as Data Controllers with the Information Commissioner's
Office?

Thankyou for your kind response. I am requesting this information as an interested member of the public...You state that the groups mentioned in 1-5 are the same group of which you are chair. May I ask what is the formal name of the group, please? Further to my email, is the group formally structured, please? Is there a board of members and what is its make-up? What formal qualifications do they hold? To whom is membership open and what is the extent of that membership?On what basis did the DoH and NHS commission your group to write care documents for publication? Does the group receive funding for its work and from whom? Is the group registered as Data Controllers with the Information Commissioner's Office?

The group is made up of 26 consultant nurse in palliative
care who are employed either by acute trusts, primary care trusts or
independent hospices.

We are all highly experienced nurses who have worked In the
field of palliative care for many years prior to assuming these roles.

The name of the group as you can tell has been under many
guises, but the final agreement on a definitive name will be debated at our
next meeting March.

As we are all clinical nurses there is no board formulation.
We have a chair and a secretary for administrative purposes only. We meet to
debate and support palliative care initiatives and to initiate best practice
models where none may currently exist.

Neither the DoH or NHS commission work from the group but we
work alongside the National End of life Care team to provide the clinical voice
for new developments and reviews. Occasionally the DoH ask for a representative
from the group to sit on working parties or review panels to provide the
clinical nursing input.

We receive no funding whatsoever either for work that we do
or for our meetings.

Regards,

Margaret

Margaret Kendall

Consultant Nurse In Palliative Care / End of Life Care Lead

It is now
established that the six groups named here –

1.The National Nurse Consultant Group (Palliative
Care)

2.The Consultant Nurses in Palliative Care
Reference Group

3.The National Palliative Care Nurse
Consultant Group

4.The National Group of Palliative Care Nurse
Consultants

5.The National Group of Palliative Care Nurse
Consultant

6.The nurse consultant group

are one and the same group
chaired by Margaret Kendall.

It is now established that
these six named groups have not existed officially under any
name at all as this matter is still to be decided at their next meeting in
March.

It is now established that
this group chaired by Margaret Kendall has had many names and yet has had
none.

It is now established that
this anonymous anomality of non-persona have had authored
and co-authored work published, given evidence to a House of Lords
Select Committee, submitted expert opinion, and been cited in reference.

1. In 2005, a group claimed to represent "all palliative care nurseconsultants in England ".- "The National Group of Palliative CareNurse Consultants"-, in their written evidence to the House ofLords Select Committee on Assisted Dying in 2005 (see:http://www.publications.parliament.uk/pa...).2. A statement by another group called the"Consultant Nurses inPalliative Care Reference Group" in 2012 (signed by an M KendallMSc BSc RGN RSCN NDN on behalf of this group on 25/10/12 ) iscurrently being displayed on the NHS National End of Life CareProgramme web portal at<http://www.endoflifecareforadults.nhs.uk...>

in support of the Liverpool Care Pathway, and what they describeas 'their colleagues at the Association of Palliative Medicine'.They do not appear to exist.3. Yet another group calling themselves the "National NurseConsultant Group (Palliative Care)" appear to have actually writtenthe Guidance on nursing the dying for the DoH/NHS in 2011. (see:http://www.endoflifecareforadults.nhs.uk...), and M. Kendall appears to have been the only named author of thisdocument. They do not appear to exist either.

There are famous - and infamous - tales of deception and
counter-deception from times of war, of one side attempting to hoodwink
and out-best the other to gain some advantage of strategy. What
deception or counter deception is this...?

LIVERPOOL “KILLING” PATHWAY – Nursing and Midwifery

Council says “Not Our Problem”

BEING former nurse and still registered and having been at the side and with people as they die I felt very strongly, like many, when I found out people were being purposely put on a euthansia programme of withdrawing all food and drink and letting them to die over days in distress and pain with only sedation and upping of medication to make them sedated and make them quiet. I also found out that unqualified and bogus paliative care groupshad been set up, it appears in name only – to add weight to the argument and use of these programmes. An important question had been posted on FOI site and I had to ask the NMC to get involved and please challenge and question it, Seeing as nurses are part of this process and our duty and care would be to not be part of killing or withdrawing food and drink to point patient dies.

It is seems, sadly to me, that the NMC does not care, and has given a pass-off, avoided response.

To After Atos

Firstly, I am sorry for the delay in responding to your email to Sara Tollerton, dated 31 December, which has been passed on to me in my role of Head of External Liaison.

The NMC has no role in the Department of Health (DoH) review of the Liverpool Care Pathway. I note the FOI request that has been made, but it is not the NMC’s role to inquire into the review, or the individuals or groups which the DoH has asked to contribute to it.

I am sorry not to have written before now.

Yours sincerely

Peter Lynn

And here isMargaret Kendallin
her own write on behalf of The Consultant Nurses in Palliative Care Reference Group -

Joint statement from the Consultant Nurse in Palliative Care Reference Group

As consultant nurses in palliative care, we are aware of the ongoing adverse media coverage about the care provided to people as they die.We are also aware of the distress and fear that negative publicity about these events causes. We wish our voices to be heard because we have extensive experience of the care of the dying and of using the guidance of the Liverpool Care Pathway (LCP) to provide and measure the quality of that care.

We deplore poor care for the dying and insist that society does all it can to alleviate the physical, emotional and spiritual distress that can occur during the days and hours that precede death. Equally we deplore the counter-productive comments made in the media which describe care of the dying as killing. Nurses and other health professionals are tending to the dying and their families every day and every night of the year. It is deeply offensive to public servants who abide by clear codes of conductand the law, to describe their dedicated work in this way. Furthermore, it significantly increases the distress for future patients and families if such suggestions are purported and we have witnessed heightened fears since media reports appeared.Death, like birth, is a natural and individual process. For some people, death is quick and painless, for others, the hours and days which precede death can also include suffering for the person, for the families and for professionals. Many aspects of that suffering can be anticipated and avoided with careful planning, communication and coordination

We are aware of the distress that some families have reported as a result of what appears to be a lack of clear communication in some areas over the purpose and process of LCP. As a result, we will continue to explore further ways of supporting improved communication skills for all relevant staffThe LCP was not introduced to 'Clear the NHS of the old and the infirm', as has been cruelly suggested in the Daily Mail. It is a specific document developed to guide the assessment, delivery and evaluation of care during the last days of life. It was developed by health workers with direct and daily experience of care for the dying.

The LCP document has been continuously updated as a result of multiple national reviews (supported by respected professional bodies). In particular, guidance about identification of the dying, communication with patients, families/carers and regular review by the multidisciplinary healthcare team is enshrined within the latest national version. The importance of culture and religion at the end of life, challenges us to be flexible with the way we deliver end of life care to everyone. We remain committed to the belief that organised and sensitive care in the last days of life is a human right. We fully support the significant efforts being made nationally to train nurses and doctors to appropriately identify the dying, to communicate sensitively and to relieve suffering.;we call for the ongoing funding for the continuation of rigorous training; particularly in the difficult conversations with distressed patients and families.We believe that use of the LCP guidance can be improved by bringing the voice of the family clearly and routinely into the planning, delivery and evaluation of care and we are developing ways to achieve this. Equally we fully support the proposal by the DH end of life care programme board for workshops and projects around integrated care pathways in end of life care and would wish to be an integral part of this work.Finally to quote from our medical colleagues from the Association for Palliative Medicine “we will continue to deliver, and support the delivery of high quality palliative care, including listening and responding to concerns and anxieties experienced by our patients and their families about many different aspects of their illness and treatment as part of our holistic approach to their care”.M Kendall MSc BSc RGN RSCN NDN on behalf of the Consultant Nurses in Palliative Care Reference Group25/10/12

About Me

I am distraught and I despair that these events have befallen this family. The picture is of me and my lovely mum, murdered on the NHS (National-socialist Health Service). Murdered. Is that too strong a word? Her life was taken without her permission. By omission and by commission, actions taken and not taken conspired to end her life. She was kept in ignorance of what was proceeding before her very eyes, as were we. Was she, then, not murdered?